I appreciated how you summarized the discussion from class in a clear, concise, and informative way. I too, am curious about the use of prazosin in children and adolescents.
A 2017 literature review validated your concerns, stating that prazosin has not been well studied in children, but that it shows favorable outcomes. Akinsanya, Marwaha, and Tampi (2016) stated that in their literature search, several of the articles found were case reports. One of these reports discussed an adolescent female with a history of neglect, physical and sexual abuse, and foster home placement. She exhibited signs and symptoms of PTSD (nightmares, difficulty sleeping, hypervigilance), depression, and anxiety. She was being treated with various medications, including nefazodone, trazodone, ambien, and mirtazapine – a combination of medications that was ineffective in addressing her symptoms. She was admitted to a long-term psychiatric facility and these medications were stopped. Prazosin was started and titrated appropriately, and within weeks, she showed significant improvement in her overall symptoms, including no nightmares and better sleep. It is important to note, however, that she also was doing therapy (group and individuals), which could have also had a positive impact on her psychological outcomes. Regardless, the fact that her nightmares stopped within several weeks is quite promising. Case reports like this provide much hope regarding the potential of utilizing prazosin with children and adolescents more routinely in clinical practice.
Akinsanya, A., Marwaha, R., & Tampi, R. R. (2017). Prazosin in Children and Adolescents With Posttraumatic Stress Disorder Who Have Nightmares: A Systematic Review. Journal of clinical psychopharmacology, 37(1), 84-88.